HOME
ABOUT
About Tovah
COACHING
Somatica Coaching
Somatic Coaching For Teens
Somatica Coaching 60 Minute Session
Somatica Coaching 10 Session Package
Enagic For Health
Enagic For Wealth
STORE
Kangen Water
RESOURCES
American Board of Sexology
Blog
CART
Client Intake
Emergency Contact (Name)*
Emergency Contact Number*
Emergency Contact Relationship*
What brings you to Sex and Intimacy Coaching? (Please share briefly what you'd like to explore or work on.)*
What are your current goals for this work?*
Do you have prior experience with therapy, coaching, or personal development work?*
Yes
No
If yes, briefly describe:
How would you describe your relationship to your body and emotions?*
Are you currently in a relationship(s)?*
Yes
No
If yes, how would you describe it?
What are your desires, challenges, or curiosities in your relationships or intimacy?*
Do you have any concerns, fears, or boundaries you would like me to be aware of as we work together?*
Have you experienced trauma, stress, or events that have impacted your relationship with your body, intimacy, or sexuality?*
Yes
No
If yes, please share only what feels comfortable:
Do you have any physical conditions, injuries, or sensitivities that I should know about?*
Do you practice any form of mindfulness, movement, or bodywork (e.g., yoga, dance, meditation)?*
What are your expectations or hopes for our sessions together?*
Do you have specific modalities or practices you are interested in exploring (e.g., touch, guided visualization, movement)?*
Are there any specific boundaries or preferences you’d like to share?
I understand that Somatic Sex and Intimacy Coaching may include verbal and experiential practices designed to help me connect with my body, emotions, and desires. I understand that my participation is voluntary, and I can set boundaries or stop at any time.*
Yes I understand.
Submit
© Tovah Petra Kolodinski
Privacy Policy
Terms & Conditions
Follow Me On Social
×
Tovah Petra Kolodinski
USA
626-695-7013
•
tpkolodinski@gmail.com
Please select
USA
Australia
Canada
Singapore
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaidjan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canary Islands
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic Of The
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji Islands
Finland
France
French Guyana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kosovo
Kuwait
Kyrgyzstan
Lao Peoples Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova, Republic Of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nambia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Paupau New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent And The Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South Sandwich Islands
Spain
Srilanka
St. Helena
St. Pierre And Miquelon
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Contact me by
Email
Text
Send Message